HomeMy WebLinkAboutStreet Cut Permit 462 Abbe Road 1000240 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 12/07/10. ; �
GIs ID:00600462N FEE: 25.00
MUNIS APPLICATION# 201001643 Z _ l '£ 'IRATION DATE: 12/07/11
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APPLICAN �� r LOCATION
NAME: HINCKLEY CONSTR INS
RE y, ABA
E
- ROAD
ADDRESS: 178 HIGHLAND VIEV yf% T�T EPH B&ERICA C
SOMERS CT 06071 z'
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�BISIHILL RD
� s TER,CT 06040
PHONE .............. �
XAC
WORK DESCRIPTION: _ WAT T
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APPLICANT AGREES TO FURNISH THE TC SITTTy A1VI�0 $ ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A C I I AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE '�L� MI t __ L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFk �TIDS IE GNU T`'E. IT MANUAL.
ISS D BY DATE ' ,PECTED INSPECTED BY
12/7/20108:46AM **•*PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /Ob -2 lio CONTRACTOR:. I�-�1 V� G/L�ca GDP ,,5* .
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:�
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT: —
INPUT: DATE: la /o
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
dojo 0/& q3 APPLICATION FOR STREET EXCAVATION PERMIT >060a (-//-)
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
'1640 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm )A, c. \< 1-e, Co
1f�`i.� Phone No. 1'?'�'t7
Address of Firm S"D 7 �1 .�� (�,r � 4� cl 166,e� Zip GodeQl ,o-- _
Location of proposed work_
Describe fully nature of permit requested
Starting date_ ) A f 3 d v 1 a Approx.time for completion
Call Before You Dig No. .3Q I o y (.0 o '4'C� ' Existing Water.Supply: 94PUblic Water Well
Existing Sewage Service: ❑ Public Sewer OSeptic
PLEASE NOTE; THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,-TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts $
Est.Patch Size(s) 'A'%9 sf
Est.Pvt.Thickness 3 ' in.
Est.Patch Unit Price$ Q •✓sf
Est:Patch Cost$
Est.Curb Replacement__lZi-__ft
Est.Curb Unit Price_$_ /ft
Est:Curb Cost$
Est.Traffic Unit Cost$ !hr
3 Est.Traffic Control$
Amt.of Deposit$
w,r�s.h. mom..,.• ,,-- ._.-_ �
Total Due$ J 00• 00
( )Cash (fKCheck#
Applicant is responsible for contacting paid B
the Police-Dept.and-C.B.Y.D. Y
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTH.WINDSOR.FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAT.I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMIT AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:(� Date:_ •i a o 14
Title: i'�C �e S Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08
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